Key Takeaway: CMS Administrator Marilyn Tavenner, R.N. told HIMSS14 attendees last week that both ICD-10 implementation and meaningful use deadlines remain unchanged. However, her agency promised to perform end-to-end testing for ICD-10, and it plans to make it easier for providers to obtain hardship exceptions if they are not able to meet MU requirements in 2014.

Why it Matters: This announcement reveals, for the first time, how policymakers are looking to mitigate sub-optimal participation in meaningful use during program year 2014. The rule is sufficiently broad to define new areas for hardship exception, but the current application of the rule only permits EHR hardship exceptions for providers whose vendor went bankrupt or is decertified. Additional details are expected from CMS soon.

Next Steps: CHIME will work closely with CMS to ensure the hardship exceptions are established in a fair manner and they address longstanding concerns. CHIME also will seek volunteers to help CMS perform ICD-10 testing.

On Monday, February 24, the first day of HIMSS14, a letter to Secretary Kathleen Sebelius, signed by nearly 50 provider organizations was made public. The letter sought more time and flexibility for providers that are struggling to meet Meaningful Use requirements in 2014. In an attempt to address these concerned – voiced by CHIME, the AHA, the AMA, AHIMA and 44 additional organizations – CMS Administrator Tavenner and National Coordinator Karen DeSalvo, M.D. acknowledged program successes and challenges. Administrator Tavenner remained steadfast on both the ICD-10 deadline (Oct. 1, 2014) and deadlines related to Meaningful Use, saying both were vitally important to broader health reform initiatives. “All of these programs [ICD-10 and MU] use tools to link outcomes, link cost of care, link quality and link payments together,” she said.

However, CMS said it was “cognizant of the concerns expressed by stakeholders regarding availability of 2014 Edition Certified EHR Technology. Therefore, HHS will implement a flexible hardship exception policy so those who legitimately tried to upgrade their EHR product to the 2014 Edition but may have not had time to implement the system would not be penalized in 2015,” the CMS said.

In response, CHIME officials said, “If the expansion of the office’s EHR Hardship Exceptions provides the kind of relief the industry desperately needs, CHIME pledges to assist policymakers in every way possible. Should CMS choose to define the new hardship exceptions in a way that does not address the core concerns of our industry, we will continue to seek the kind of flexibility that nearly 50 national healthcare organizations communicated to HHS Secretary Kathleen Sebelius on February 21, 2014.

Many CHIME members continue to voice concerns over code delivery and implementation challenges related to both ICD-10 and MU. Please contact Jeffery Smith, Senior Director of Federal Affairs, with any questions or comments concerning your facility’s readiness for looming ICD-10 and MU deadlines in 2014.

ONC Proposes New Voluntary EHR Certification Criteria

Key Takeaway: The ONC released its first set of voluntary EHR certification criteria, building on an “Edition” construct first established as part of Stage 2 rules.

Why it Matters: ONC believes this approach, developing a 2015 Edition voluntary certification before a mandatory 2017 Edition, will enable more efficient software development and deployment.

The Office of the National Coordinator published a notice of proposed rulemaking (NPRM) last week, which “marks the first time ONC has proposed an edition of certification criteria separate from the Centers for Medicare & Medicaid Services' meaningful use regulations.” The 2015 Edition certification is voluntary, meaning that EHR developers would not be required to incorporate new criteria – and providers would not have to adopt new technology – to demonstrate Meaningful Use in 2015 or 2016.

The bulk of the certification rule would leave 2014 Edition criteria unchanged, officials noted, and it defines “gap certification,” that would enable developers to use previous certification results to qualify for future certifications. The remainder of the proposed regulation includes:

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